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What % of pple have a common caniliculus?

90%

1

Name common benign lacrimal gland tumor

Pleomorphic adenoma
Aka benign mixed tumor

2

Whats the most common type of melanoma on the face?

Lentigo maligna

3

whats kassabach merrit syndrome?

thrombocytopenia in capillary hemangioma 2/2 plt sequestration

4

whats a hemangiopericytoma?

round encapsulated within cone needs to be excised completely can be benign or malignant and can look like cav hemangioma

5

lacrimal gland tumors: 50% inflammatory (painful) and 50% tumors- what are the 2 types of epithelial tumors?

adenoid cystic ca
benign mixed cell tumor

6

how do you treat benign mixed tumor of lac gland?

complete excision including capsule. Why not incisional biopsy? bc it has malignant potential

7

what are the causes of inflammation of the lacrimal gland?

sarcoid- painful
IOI- painful
Lymphoma- NOT painful

8

whats the most important consideration in chosing a ptosis surgery?

amount of levator fxn

9

whats a fasanaella?

remove mullers and top 1/3 of tarsus

10

in both TAO, and CC fistula there are angry conj vessels How do the 2 presentations differ?

CC fistula the mad vessels go right up to limbus. In TAO theres a clear zone w no angry vesses between muscle and K

11

what are the symptoms of IOI?

Deep pain, EOM restriction, chemosis, pain w eom,

12

whats the first part of the orbit to be affected by IOI?

Lacrimal gland

13

whats the next step in rx if steroids fail for IOI?

Radiation

14

how does sarcoid usually present in the orbit? uni or bilateral?

bilateral lacrimal gland swelling

15

whats the cause of a CC fistula?

basal skull fracture

16

whats a dural cavernous fistula, who gets it, whats the cause?

1) menigeal artery commun w cav sinus
2) old pple
3) htn, atherosclerosis

17

does a varix present w proptosis or enophthalmos?

both!
proptois upon valsalva and enophthalmos upon rest

18

how do you treat optic n glioma?

complete excision

19

what does a meningioma arise from?

arachnoid villi

20

meningioma is described as "fusiform tumor" what does that mean?

fusiform = tapered on the ends (as opposed to gliom which is not)

21

what does a sphenoid wing meningoma look like on ct?

hyperostosis of the surrounding bone

22

how do you treat sphenoid wing meningioma?

observe till visually significant. If so, then debulk tumor. Complete excision is impossible

23

how do you treat a optic nerve meningioma that is visually significat?

radiation

24

whats "fibrous dysplasia"

benign condiition of hyperostotic bone in face. Need to debulk.

25

how does neuroblastoma present besides horners?

abrupt eccymotic protosis

26

whas a CDCR?

Connect carucle into middle meatus w pyrex tube. it completely bipasses the canalicular system

27

if youre doing a DCR and find abnormal tissue what do you do?

frozen section of the specimen

28

what do you connect in a dcr?

lacrimal sac to middle meatus (bypass lower portion of lacrimal system that drains into inferior meatus)

29

2-8-12-15mm

punctum- canaliculus-lac sac- NL duct

30

2-8-12-15mm

punctum- canaliculus-lac sac- NL duct

31

whats the bick procuedure whats it used for?

LL ectropion- cut full thickness flap out of lateral lower lid and close primarily- may cause "rounding" of canthal angle if heals like shit

32

whats the medial spindle procedure whats it used for?

medial LL ectropion or LL punctum turned out- excise conj and retractors medially in a diamond configuration (ie posterior lamella) and close

33

where do the frontal, ethmoidal, and maxillary sinuses drain?

middle meatus

34

Bones of orbital roof

Frontal
Lesser wing of sphenoid

35

Lateral orbital wall bones

Zygomtic
Greater wing of sphenoid

36

where are glands of Krause and where are wolfring?

Krause- superior fornix
wolfring- NON-MARGINAL tarsal border
Julie Krause has to be superior to everyone else

37

ASPERGILLUS CELLULITIS CAUSES WHAT LAB ABNORMAILTY

Hgh IgE

38

what % of pple with hyperthyroid get TAO?

30%

39

whats more common primary meningioma (ie arising from the ON) or secondary orbital meningioma?

secondary orbital meningioma

40

what does ON meningioma arise from
what does secondary orbital meningioma arise from?

1) arachnoid villi
2) intracrainial site like sphenoid or clinoid

41

Developing lymphoma in which part of the eye confirs the greatest risk of systemic non-hodgkins lymphoma?

eyelid

42

what causes involutional LL entropion?

disinsertion of retractors
horizontal laxity

43

Whats a synonym of blue nevus

nevus of ota

44

whats the cell of origin in kaposis sarcoma?

endothelial! (lymphatic endothelium forming vascular channels)

45

What 2 structures does the IO separate?

medial and central fat pads of LL

46

Where does CN7 run in the upper face?

IN the SMAS

47

where does cn7 run in the lower face

deep to smas

48

name layers of face

epidermis
dermis
subQ fat
smas
deep facial facia

49

where does levator aponeurosis insert?

into pretarsal orbicularis and skin (makes the crease)

50

why Asian eyelid the way it is?

bc septum fuses w levator aponuerosis lower down allows fat to have lower positioning

51

whats a normal LF?

12-15mm

52

whats a normal mrd1

4mm

53

where does superior septum arise from and where does it insert?

superior periosteum
fuses w levator aponeurosis above tarsus

54

where does inf septum arise from and where does it insert?

inferior periosteum
fuses w capsulopalpebral fascia below inferior tarsus

55

where does levator originate from

lesser wing of sphenoid

56

what does whitnall ligament do?

transitions from levator muscle to aponeurosis

57

where does the anterior portion of levator aponeurosis insert? where does posterior insert?

anterior- pretarsal skin and orbicularis
posterior- anterior surface of lower half of tarsus (dehiscence=ptosis but LF remains normal bc ant portion still ok)

58

what does the lateral horn of the levator do?

divided lacrimal gland

59

where does mullers insert?

sup border of tarsus

60

where does medial canthal tendon insert?

ant and post lacrimal crest

61

wheres the peripheral arcade?

above tarsus

62

wheres marginal arcade?

2mm above lid margin

63

where does medial face lymph drain into?

submandibular

64

where does lateral face lymph drain into?

pre-auricular

65

whats the triad of blepahrophimosis and inher?

AD
1.telecanthus
2.epicanthi inversus
3.ptosis

66

in what systemic dz can you see congenital eyelid eversion?

ichthyosis

67

wheres epicanthus inversus

inferior/lower lid

68

wheres epicathus tarsalis?

tarsalis= top (upper lid)

69

wheres epicanthus palpebralis?

equal upper and lower

70

where epicanthus supraciliaris?

eyebrow

71

whats epiblepharon

Asian kid w eyelashes up

72

when eyelid coloboma is isolated finding where is it usually located?

upper eyelid

73

when lid coloboma is in the lower lid, its ass w?

goldenhaar

74

whats the soft yellow things josh has below his lid?

syringoma (benign eccrine gland papule)

75

when do eccrine hidrocystomas enlarge?

warm weather/sweating

76

if defect is 33% or less

direct closure

77

if defect is 33-50%

semicircular flap

78

if defect >50%

cutler beard
modified hughs

79

how to correct mild ptosis

fasanella

80

how to correct ptosis if LF is 4-8mm

levator resection

81

if levator fxn is <4mm how to correct?

sling

82

how to correct aponurotic ptosis

levator advancement

83

whats blepharochalasis

rare inflammatory dz in young females lids become thin

84

when does the lacrimal gland start working?

6 wks

85

if you have to remove puncta 2/2 sebaceous cell do you do dcr at same time?

no. observe bc don't want to spread the cancer. do dcr at later time

86

How long before surgery should each of these drugs be stopped
NSAID
Coumadin
ASA

NSAID- 3 days
Coumadin- 4 days
ASA 5 days
(reverse alphabetical order)

87

most common INFECTIOUS cause of dacryoadenitis

EBV
Mumps = #2 and will be bilateral!

88

whats a "direct" fracture?- think baseball bat to face

naso-orbital-ethmoid fracture
epistaxis
rounding of medial canthal angle
telecanthus

89

whats Lefort 1?

?

90

whats lefort 2?

?

91

whats lefort 3?

?

92

Most common cause of pre-septal 2/2 a scratch?

s. aureus

93

whats the weakest part of the maxilla?

posterior-medial

94

whats a stye?

external hordeolum
(infection of zeiss gland)

95

whats an internal hordeolum?

infection of meibom gland oricifes

96

when a kid w congenital ptosis looks down, why is there lagophthalmos and lid is high?

bc lid is fatty and doesn't go all the way down

97

whats another name for apaneurotic ptosis?

involutional ptosis

98

how much ptosis can you repair w a fasanella

2
if theres more ptosis than 2, you have to touch the levator